s-1, surplus property transaction form – uthsc …submit s-1 electronically to [email protected]...
TRANSCRIPT
S-1 Surplus Property Transaction Form 11/19/2019 Rev8
S-1, SURPLUS PROPERTY TRANSACTION FORM – UTHSC CAMPUS Date: Page of
\
R
Dept.: Account Name: Building Code: Building Name/Address:
Requestor/Contact: Email: Requestor/Contact Phone No.: Pick up/Remove On or Before:
Special Handling or Expediting, please Explain:
Dept. Head/Business Mgr./Designee Typed Name: Email:
Signature:
INSTRUCTIONS: Fill in S-1 form online only as hand-written is not accepted. Submit S-1 electronically to [email protected] Note: Each item previously used in connection w/biological, chemical and/or radioactive materials must be decontaminated & a separate S-3 Equipment Decontamination Form filled out/signed and a copy submitted electronically along with the S-1 before acceptance by Surplus & release to Logistics for pickup. Forward a copy of each S-3 to Safety Affairs. Retain copies of signed S-1 forms for six (6) years per UT Policy and do not forward to Controller’s Office as this task is accomplished by others.
NOTE: Surplus personnel will enter a Work Order in Archibus to have surplus picked up.
Room No.
QTY Item Description, Mfr., Model Condition Code(s)
Serial Number UT Inv. Tag Number
Asset Number Listed
on Equip.
Inv.
Surplus Rec’d by Logistics Personnel/Signature ONLY:
Date:
Surplus Rec’d by Surplus/Personnel Signature ONLY:
Date:
Surplus Use Only
R S D E